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CA LA VERAS Delivery Tag <br /> 4 HE�DELBERGCEMENTGroup <br /> Weighmaster Certificate CUSTOMER COPY 2 <br /> Calaveras Materials Inc. <br /> 7673 N. Ingram Avenue <br /> Fresno,CA 93711-5838 <br /> Phone 559-277-7060 <br /> Toll Free 800-726-5615 <br /> Load Leave Plant Arrive Job Start Pour End Pour Leave Job Arrive Plant <br /> Water Added on Job at Customer <br /> Customer's Request Gallons Signature x <br /> WEIGHMASTER CERTIFICATE: THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted by a weightmaster,whose <br /> signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the <br /> California Business and Professions Code,administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br /> CAUTION: PORTLAND CEMENT IS INJURIOUS TO EYES: CAUSES SKIN IRRITATION. READ WARNING ON REVERSE SIDE OF THIS FORM FOR <br /> DETAILED INSTRUCTIONS. <br /> Plant Ticket No. Order No. Customer No. Sold To: Date <br /> Delivery Address Zone Driver <br /> Special Instructions Project No. <br /> Special Instructions Job Number <br /> Truck No. Load Size Mix Code Slump %Air %Call. Project Name: <br /> Load Cumulative Ordered Unit of Product Product Unit Amount <br /> Quantity Quantity Quantity Measure Code Description Price <br /> CALAVERAS MATERIALS INC.ASSUMES NO CERTIFICATE OF COMPLIANCE: WE CERTIFY that the <br /> RESPONSIBILITY FOR DAMAGE INCURRED IN portland cement,chemical and mineral admixtures contained in <br /> DELIVERING MATERIALS INSIDE THE CURB LINE. the material described below are brands stated and comply with <br /> specifications: <br /> CALAVERAS MATERIALS INC. CEMENT BRAND: Sub total <br /> TYPE: 11 MILL LOCATION: Tax <br /> CHEMICAL ADMIX BRAND: TYPE: <br /> MANUFACTURER: <br /> By MINERAL ADMIX MANUFACTURER: <br /> CLASS: <br /> Total <br /> CONTROL 1 <br /> NO. DO NOT USE FOR TICKET NO. <br /> FORM k WC(Rev.5/06)X289327 <br />